Research Roundup: March 2021
Mar 27, 2021
Interested in keeping up to date with research relevant to your clinical practice?
The Calibrate Pilates team rounds this up so that you can integrate new information into your evidence-informed practice: join our newsletter now.
Effects of Daily Hand Activities on Age-Related Declines of Dynamic Motor Function in Individual Fingers
Aoki T, and Kadota K. Effects of Daily Hand Activities on Age-Related Declines of Dynamic Motor Function in Individual Fingers. Motor Control (Ahead of Print). https://doi.org/10.1123/mc.2020-0085
This small study compared the dynamic and static motor capacities of each finger among elderly individuals who engaged in hobbies that involved daily use of the hands, and those that did not.
- Aging is characterized by a decline in manual dexterity, and may be quantified by decreased grip force, decreased tapping frequency, and prolonged timing for the pegboard test.
- Reports from static motor function studies on individual fingers show that the lower maximum pinch force in older adults is greatly reduced, compared with young adults.1
- Pinch force is a precision grip whereby an object is pinched in three ways: lateral pinch, three-point pinch, and two-point pinch.2
- Individual fingers have a lower maximum flexion force in the elderly.3
- Training and daily use have the potential to maintain finger motor function in older adults.
- Skilled finger training movement can improve an individual’s ability to control hand steadiness, submaximal pinch force, and manual speed in older adults.
- Results from the study showed that daily use of the hands in older adults could help to prevent age-related declines in dynamic motor function in individual fingers.
- Gender differences could not be ruled out, as there were not enough inactive female participants included in the study.
Clinically: Pilates in Practice
Integrate finger mobility and different grips/pinches into functional hand exercises.
- Lateral pinch.
- Three-point pinch.
- Two-point pinch.
Use different straps/handles for arm work, with a focus on finger positioning.
- Integrate tapping motions of the fingers with isometric holds through the elbow and wrist: midback series on the Reformer; standing arm press at the Tower; seated triceps press at the Wunda Chair; Rocking on the mat.
1. Ranganathan, V.K., Siemionow, V., Sahgal, V., & Yue, G.H. (2001). Effects of aging on hand function. The Journal of the American Geriatrics Society, 49(11), 1478–1484. PubMed ID: 11890586 doi:10.1046/j.1532-5415.2001.4911240.x
2. Poh Kiat Ng, Adi Saptari, Qiao Hui Boon, Meng Chauw Bee, Ka Xuan Chai and Shiong Lung Leh, (2014). Pinch Effort Variations with Torque, Shape, Size, Sensation and Technique. Journal of Applied Sciences, 14: 401-414.
3. Shinohara, M., Li, S., Kang, N., Zatsiorsky, V.M.,&Latash, M.L. (2003). Effects of age and gender on finger coordination in MVC and submaximal force-matching tasks. Journal of Applied Physiology, 94(1), 259–270. PubMed ID: 12391031 doi:10.1152/japplphysiol.00643.2002
Passive Motor Learning: Oculomotor Adaptation in the Absence of Behavioral Errors
Cain, Matan, Yehudit Botschko, and Mati Joshua. "Passive Motor Learning: Oculomotor Adaptation in the Absence of Behavioral Errors." eneuro 8, no. 2 (2021), ENEURO.0232-20.2020. doi:10.1523/eneuro.0232-20.2020
The authors of this study challenged the long-held belief that motor adaptation might be a trial-and-error process, where the accuracy of a particular movement improves with repetition of the behavior.
- Learning is best understood through behavioral identification of the signals that drive learning, thus revealing their implementation at the neuronal level.
- Motor adaptation is a valuable model for studying learning because experiments can generate perturbation and behavioral changes can be tracked on a trial-by-trial basis.
- Movement and sensory signals converge in the cerebellum to drive adaptive motor learning.
- Motor adaptive learning can be elicited in the absence of movement.
- Sensory feedback on movement plays an important role in driving motor adaptation.
- The cerebellar flocculus is involved in the development of a predictive response to an instructive change in target during active motor learning.
- An association between motor output and sensory feedback is not necessary to elicit an adaptive response.
- When a motor command is executed in error, the climbing fiber input to the cerebellum drives plasticity that results in a more accurate upcoming event.
- Sensory errors due to inaccurate movement drive climbing fiber input; the pairing of the climbing fiber input with Purkinje cell input causes an associative reduction in synaptic strength, which in turn contributes to subsequent improvement in behavior.
- Selective attention in humans focuses around the fovea, which is the area of the retina that provides the highest spatial resolution.1
- The oculomotor system subserves foveal function via direction and stabilization of images of interest to that location on the retina.1
- Motion can be sensed covertly without eye movement, making it possible to tease apart the relationship between movement and prediction target trajectory.
- Theories of motor learning often assume that sensory feedback on movement errors in learning trials drives subsequent learning.
- Fixation trials play an important role in the development of the learned response.
- Fixation trials affects the subject’s internal state relevant to learning and choice.2
- In typical tasks, we can expect two types of fixation behavior: the relative time spent on each option when deciding, and the precise fixation time when gaining feedback about the consequences of choices.3
- Results from the study show that motor adaptation can be elicited in the absence of movement.
1. Angélica Pérez Fornos, Jörg Sommerhalder, Benjamin Rappaz, Marco Pelizzone, Avinoam B. Safran. (2006). Processes Involved in Oculomotor Adaptation to Eccentric Reading. Invest. Ophthalmol. Vis. Sci; 47(4):1439-1447. doi: https://doi.org/10.1167/iovs.05-0973.
2. Krajbich I, Armel C, Rangel A (2010). Visual fixations and the computation and comparison of value in simple choice. Nat. Neurosci. 13, 1292–1298.
3. Hrvoje Stojić, Jacob L. Orquin, Peter Dayan, Raymond J. Dolan, Maarten Speekenbrink (2020). Uncertainty in learning, choice, and visual fixation. Proceedings of the National Academy of Sciences Feb 2020, 117 (6) 3291-3300; DOI: 10.1073/pnas.1911348117
Motor Control Exercises Compared to Strengthening Exercises for Upper and Lower Extremity Musculoskeletal Disorders: A Systematic Review with Meta-Analyses of Randomized Controlled Trials
Lafrance, Simon, Philippe Ouellet, Reda Alaoui, Jean-Sébastien Roy, Jeremy Lewis, David H. Christiansen, Blaise Dubois, Pierre Langevin, and François Desmeules. "Motor Control Exercises Compared to Strengthening Exercises for Upper and Lower Extremity Musculoskeletal Disorders: A Systematic Review With Meta-Analyses of Randomized Controlled Trials." Physical Therapy, 2021. doi:10.1093/ptj/pzab072
This systematic review compared the efficacy of motor control exercises to strengthening exercises for adults experiencing lower or upper extremity musculoskeletal disorders. However, the results were inconclusive due to a lack of long-term follow-up from the included trials and the absence of performance-based outcomes.
- Adults with musculoskeletal disorders experience strength deficits and neuromuscular control impairments, thus necessitating the need for motor control exercises and strengthening exercises.
- It is not clear if motor control exercises are more effective in the treatment of musculoskeletal disorders as compared to strengthening exercises.
- Out of the 21 randomized controlled trials examined, 14 RCTs involved participants who had lower extremity musculoskeletal disorders, and 7 with upper extremity musculoskeletal disorders.
- The quality of evidence of the study was moderate in the short-term and low-quality in the mid-term.
- Moderate quality evidence was obtained during secondary analyses. This excluded osteoarthritis conditions on disability and pain-related results.
- Scapula-focused exercise programs including motor control exercises are believed to be superior to general physical therapy (manual therapy, strengthening exercises, stretching, and electrophysiological modalities).
- For patellofemoral pain syndrome, core and hip exercises are found to be superior to knee-focused exercises in terms of pain and disability.
- Motor control exercises should focus on the improvement of neuromuscular control, movement quality, and joint stability while strengthening exercises should address strength deficits.
- Motor control exercises lead to statistically greater disability and pain reductions when compared to strengthening exercises among adults with upper and lower extremity musculoskeletal disorders.
- Motor control exercises target the activation of specific musculature, dynamic muscular stabilization exercises, neuromuscular control exercises, proprioceptive exercises, and movement control exercises.
- Strengthening exercises require a form of resistance.
- Forms of resistance include elastic resistance, body weight, and machine weights, but with no emphasis on motor control.
- Motor control exercises reduces pain and disability in adults with upper or lower extremity musculoskeletal disorders compared with strengthening exercises. However, these differences are not clinically important.
Clinically: Pilates in Practice
- When selecting exercises for treatment, what is the functional goal and/or outcome?
Consider: motor control exercises should focus on the improvement of neuromuscular control, movement quality, and joint stability, while strengthening exercises should address strength deficits.
- For strengthening, consider intensity, repetitions, sets, rest periods, and frequency of training.
- For motor control, watch for precision and quality of movement. Add proprioceptive and other somatosensory inputs as appropriate. Work within the Zone of Proximal Development.1
1. Zoglowek, Herbert, and Maria Aleksandrovich. "Motor Learning in the Zone of Proximal Development." In Contributions to the Development of the Contemporary Paradigm of the Institutional Childhood. Lit Verlag, 2017.